Audit of SGIM in medical school pre-clinical curriculum

Wasden, Katherine 1 ; Bartz, Deborah 1 2

Published Jul 24, 2025 on Dryad. https://doi.org/10.5061/dryad.djh9w0wbr

Data files

Jul 24, 2025 version files 118.07 KB

Audit_of_SGIM_in_Pre-Clinical_Curriculum.xlsx
92.81 KB
README.md
25.26 KB

Abstract

Despite the expanding literature demonstrating widespread sex and gender differences across all organ systems, the inclusion of this material in medical education is lacking, leaving medical students without an appreciation for physiologic and sociocultural differences that affect health, disease, and healthcare delivery. We performed an audit of five courses of a medical school's pre-clinical curriculum that teach physiology and pathophysiology using case-based collaborative learning (CBCL) that utilizes "patient" cases for students to work through during class. The courses (referred to as “Courses 1-5”) divided material as follows: 1) biochemistry, anatomy, genetics, immunology 2) dermatology, infectious disease, rheumatology 3) cardiology, pulmonology, hematology 4) gastroenterology, nephrology, endocrinology, and 5) neurology, and psychiatry. Using a standard codebook, reviewers recorded: time per case, diagnosis/focus of case, age, sex, gender, pronouns, and sexual orientation. Coders were asked to determine if the CBCL patient’s sex/gender chosen was “intentional” and if there was further discussion around sex- and gender-specific influences on disease. Each case was coded by two auditors, with discrepancies adjudicated by a third. This file contains the coded data from the cases, which were originally retrieved from the school's web-based learning management system.

Dataset DOI: 10.5061/dryad.djh9w0wbr

Audit_of_SGIM_in_Pre-Clinical_Curriculum.xlsx

Description of the data and file structure

File: Audit_of_SGIM_in_Pre-Clinical_Curriculum.xlsx

Description:

First sheet of data includes the codebook for data analysis.
Sheets for courses 1-5 include data collected from 591 individual patient cases created for pre-clinical medical education (cases are not real patients, and the data collected does not include real patient information). The variables collected are listed below.
The sheet entitled "Intentional SG" (sex/gender) collects the cases across all course sheets that had "Y" listed for S/G/P intentional, specifically including the diagnosis, gender, and sex of the patient, as well as whether further discussion was had. Additionally, it includes the reason why the S/G/P were thought to be intentional (marked as a 1; cases could have multiple reasons), broken down into: disease prevalence ("Prevalence"), physiology, menses (i.e. menses were crucial to the design of the case), pregnancy, and practice of medicine.
Finally, the sheet entitled "Further Discussion" collects the cases across all course sheets that had a further discussion of sex/gender and the disease process.

Variables

Missing values are either indicated with: u=unspecified or a blank cell

Organ system	Defined for each class by course directors in syllabus	Per syllabus: Histology, CBB (cell biology and biochemistry), genetics, anatomy, immunology, microbiology, pathology, developmental biology, cancer, pharmacology, dermatology, rheumatology, ID (infectious disease), pulmonology, cardiovascular, hematology, GI (gastroenterology), endocrinology, nephrology, neurology, psychiatry integration (course 3= integration of pulmonology, cardiovascular, and hematology; course 4=endocrinology, GI, and nephrology)
Time	Time calculated per case (number of CBCL cases divided by total class time dedicated to CBCL)	Minutes; Calculate by taking total time allotted for class session, divided by the number of cases included in the class session
Case	Which case from all cases included in that individual class period (ex: 1/3 is the first of three cases)
Diagnosis	What was the final diagnosis or focus of learning (if no official diagnosis is given) of the case?
Age	As stated specifically in the case, typically in years for children and adults and months in infants.	Code in years (specify unit if not recorded in years); unspecified = u.
Gender	Gender identity explicitly stated in a sentence or in introduction of the patient as man, woman, or non-binary (or can utilize pronouns as presumption of gender). Non-binary defined as explicit statement that patient uses they/them pronouns or explicit mention in the case that patient identifies as non-binary.	Man = m; woman = w; non-binary = nb; unspecified = u.
Sex	Stated explicitly as male, female, intersex, or sex assigned at birth. If unspecified, biological and physiological references such as anatomy, chromosomes, or multiple secondary sex characteristics, can be used.	Male = m; female = f; unspecified = u
How Specified (Patient sex)	How was biological sex explicitly demonstrated in the content of the case.	Freeform
Pronouns (PN) specified	Yes: pronouns are explicitly stated either in an introductory sentence (eg. Patient uses ____ pronouns) or in parenthesis in the introduction of the patient; implication that pronouns used were provided by the patient (e.g. Patient Jane (she/her) is a 30-year-old…).	Y/N
Pronouns (PN) Used	Pronouns used for the patient throughout the case text.	he/him, she/her, they/them, u = unspecified
Sex/Gender (S/G) Intentional	By coder impression, was the sex/gender of the patient integral to the content of the case or believed to be specifically chosen by the faculty in case development (Yes)? Or was patient sex/gender irrelevant to the medical content of the case (No)?	Yes (y) or no (n); followed by freeform option
Intercourse Relevant	Is sexual intimacy mentioned or implied as having impacted the patient’s health in the case?	Yes (y) or no (n)
Partner mentioned	Is a romantic or intimate partner mentioned in the case?	Yes (y) or no (n); followed by freeform option and record of partner gender.
Sexual Orientation	If a romantic or intimate partner is mentioned in the case, is the partner’s gender the same (concordant) or different (discordant) than the patient’s gender, or is it not mentioned (unspecified).	Concordant = c; discordant=d; unspecified=u
Further Discussion	Did the case include an explicit mention, even minor, of the impact of sex and/or gender on health related to the medical condition discussed in the case? Please yes (y) or no (n) into appropriate categories: - Disease presentation: Is there a discussion of differences in disease presentation between sex and gender? - Statistics: Are there statistics about the disease by sex or gender? - Anatomy: Are anatomical differences by sex discussed? - Physiology: Are physiological differences by sex discussed? - Response to Treatment: Are differences in response to treatment discussed? - Risk Factor: Is sex or gender discussed as a risk factor? - Socioeconomic Factors: Are socioeconomic differences between sexes/genders discussed as these relates to their health and care? - Interaction with the Healthcare System: Is there a discussion of the patient's engagement or interaction with the healthcare system as it impacts their health and care?	Yes (y) or no (n); followed by freeform option

Code/software

This data is able to be downloaded and viewed as an excel spreadsheet or as a CSV file.

Access information

Other publicly accessible locations of the data:

This data is also available at the following source:

Bartz, Deborah. Audit of SGIM in Medical School Pre-Clinical Curriculum. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2025-02-24. https://doi.org/10.3886/E220587V1

Data was derived from the following sources:

Data was collected from Case-based collaborative learning (CBCL) cases utilized in Harvard Medical School's pre-clinical curriculum. These cases were accessed via the school's web-based learning management system, which is not publicly available for access.